title: Non-cancer life stressors contribute to impaired quality of life in ovarian cancer patients.
abstract: OBJECTIVE
  Diagnosis and treatment for a life threatening illness such as cancer are known to be psychologically impactful. However, little is known about the influence that non-cancer life stressors have on the quality of life (QOL) of ovarian cancer patients. The goal of the present study was to examine associations between non-cancer life stressors and QOL in 123 women with invasive epithelial ovarian cancer who were followed prospectively and longitudinally for one year.
  
  
  METHODS
  Mixed models for repeated measures were used to examine the relationship between life stressors and QOL pre-surgery and one year later, while adjusting for age, cancer stage, depressive symptoms, anxiety, and chemotherapy status (at one year). Prospective associations between QOL pre-surgery and one-year QOL were also examined.
  
  
  RESULTS
  Number and severity of life stressors were unrelated to QOL of participants before surgery. At one year, however, participants experiencing a greater number of life stressors reported poorer concurrent physical well-being (PWB) (p=0.015), functional well-being (FWB) (p<0.0001), social well-being (SWB) (p=0.0003), and total QOL (p<0.0001). Similar effects were found for life event severity. Finally, experiencing a greater number of life stressors pre-surgery predicted poorer overall QOL one year post-diagnosis (p<0.0001).
  
  
  CONCLUSIONS
  Non-cancer life stressors can substantially impact long-term QOL of ovarian cancer patients, adjusting for medical variables such as chemotherapy and cancer stage, thus highlighting the importance of evaluating the stress burden of patients in ongoing cancer care.
authors.affiliation: Department of Psychology, University of Iowa, USA; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, USA; Department of Urology, University of Iowa, USA; Holden Comprehensive Cancer Center, University of Iowa, USA. Electronic address: Susan-lutgendorf@uiowa.edu.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Lutgendorf
authors.forename: George M
authors.initials: GM
authors.lastname: Slavich
authors.forename: Koenraad
authors.initials: K
authors.lastname: Degeest
authors.forename: Michael
authors.initials: M
authors.lastname: Goodheart
authors.forename: David
authors.initials: D
authors.lastname: Bender
authors.forename: Premal H
authors.initials: PH
authors.lastname: Thaker
authors.forename: Frank
authors.initials: F
authors.lastname: Penedo
authors.forename: Bridget
authors.initials: B
authors.lastname: Zimmerman
authors.forename: Joseph
authors.initials: J
authors.lastname: Lucci
authors.forename: Luis
authors.initials: L
authors.lastname: Mendez
authors.forename: Katherine
authors.initials: K
authors.lastname: Collins
authors.forename: Anil K
authors.initials: AK
authors.lastname: Sood
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000473:pathology / Q000523:psychology; D003863:Depression / Q000209:etiology / Q000473:pathology / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000523:psychology* / Q000601:surgery; D011788:Quality of Life; D013315:Stress, Psychological / Q000473:pathology / Q000523:psychology*
keywords: Anxiety; Depression; Life events; Life stress; Ovarian cancer; Quality of life